C10007497 / invoice 10000

Appointment Notes: R dew claw sore - licking at it, sore. PVH?????History:Presented for a sore, chipped front claw of two days duration, with associated licking. The owner also reports Poppy vomited a ball of grass two weeks ago, ate grass this morning, and produced one small, soft stool. The owner is concerned about potential nausea. Poppy is otherwise eating and drinking normally with no coughing or sneezing. She drinks from a clean bowl at home and is prevented from drinking from puddles or communal bowls on walks.- Significant history: A small cutaneous cyst ("buck") is present and has been slowly growing.- Current medications: None.- Appetite & diet: Appetite normal. Fed Prime 100 roll and a good quality kibble.Examination:Vital Signs: BAR, HR WNL, RR WNL, Temp WNL, MM pink, CRT <2sec, Skin tent WNL- Eyes: No blepharospasm, no conjunctival hyperemia, no epiphora.- Ears: Ears clean, no malodour.- Oral: Small cutaneous cyst noted on lip margin.- Nose: NAD.- Cardiovascular: No murmers or arrythmias.- Respiratory: Clear bronchovesicular sounds on all lung fields.- Skin: Small clump of comedones noted. Claw lameness not evident on examination; all claws well-attached and non-painful on palpation.- Abdomen: Mildly tense on palpation, lip licking noted during examination suggestive of nausea.- MSK: Ambulating normally. WBx4, good ROM all joints. No spinal pain.- Lymph nodes: Submandibular, pre-scapular and popliteal LNs WNL.- Urinary/Genital/Rectal: Not assessedAssessment:Problem List:* Giardiasis (confirmed on positive in-house SNAP test)* Nausea* Soft stool* Cutaneous cyst (incidental finding)Treatment:- Giardia SNAP test: Positive.- Anti-nausea injection: Administered in-clinic.- Nail trim: Performed. Quicked one nail, haemostasis achieved with styptic powder.Plan:* Dispense antibiotic/antiparasitic tablets - 1.5 tablets orally with food, twice daily for 7 days.* Dispense anti-nausea oral liquid - 15 mL orally with food, once daily for 5 days.Client Communications:* Discussed positive Giardia diagnosis and its prevalence locally, especially after rain.* Advised on environmental decontamination: wash all bedding on day 1 and day 7 of treatment and pick up faeces immediately.* Informed of zoonotic potential and importance of hand hygiene.* Advised to monitor other dog (Minnie) for clinical signs and to submit a faecal sample for testing if symptoms develop.* Explained one nail was quicked during the trim and styptic powder was applied.?????    Vital Signs    Weight: 28.3;